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But this has proved particularly problematic in the more paternalistic care homes where any hint of sexual congress between residents is frowned upon.
For some time now medical care has had a more patient-centred focus, with patients expecting to be given more autonomy as a partner in determining their own treatment rather than merely a passive recipient of paternalistic care.
Qualitative data obtained from in-patient settings contextualises these findings by showing that requests to endorse a paternalistic care plan retrospectively can engender anxiety among service users, who may attribute legality to their actions and fear retribution should they fail to comply.
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To change healthcare from a paternalistic system to care where patients are seen as partners may require pedagogical skills.
This reflects a global shift in medical ethics over the last 50 years away from paternalistic models of care, grounded on a certain understanding of beneficence and non-maleficence, toward more patient-centered models grounded on autonomy and truthfulness.
In-depth qualitative data suggest that the primary driver for this involvement is the desire of service users and carers to move away from traditional, paternalistic models of care towards more patient-centred approaches capable of prioritising and responding to individual need.
Although the move away from paternalistic models of care towards collaborative models in which decision-making is shared between patient and professional has been widely promoted by policy initiatives [ 29, 30] we found many practitioners were very anxious about where responsibility lay when a patient was required to take more responsibility in practice.
Mr. Bush, for example, really does come from a three-generation family political tradition that believes that conservatism should be leavened with a paternalistic kind of caring.
The paternalistic model of patient care has also encompassed the field of research in critical care for many years.
He said: "If criticism is to be made, it is that the prison had adopted a quite paternalistic approach to prisoner care, although we clearly discerned a platform from which it could further progress.
However, although patients' rights, including their rights to decide, have increased over the last few decades, there are still remnants of the paternalistic culture in health care.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com